Clinical Application and Biomechanics of Various Lingual Retractors with Temporary Skeletal Anchorage Devices: A Narrative Review

Abstract

The lingual retractor is an appliance with esthetic advantages and biomechanical superiority in the retraction of anterior teeth, when used in combination with temporary skeletal anchorage devices (TSADs). These appliances can address the patients’ chief complaint during the early stages of bialveolar protrusion treatment. This narrative review presents the clinical applications and biomechanics of various lingual retractors with TSADs.This review includes all research and case reports related to various lingual retractors such as the C-lingual retractor (CLR), double J retractor (DJR), and antero-posterior lingual retractor (APLR). Anterior torque and vertical control can be achieved with all three types of lingual retractors by changing the length of the lever arms and the position of the TSADs. Torquing springs in DJR are designed to slide along palatal mini-implants or to apply intermaxillary elastics to counteract retroclination of the incisors during space closure. APLR allows three-dimensional control of the anterior tooth movement with anterior lever arms, guide bars, posterior tubes, and position of TSADs. Various lingual retractors with TSADs are effectively proper anterior torque and vertical control.